由于非特异性症状和复杂的脑液压力动力学，脑积水是一种具有挑战性的神经外科疾病。通常，儿童脑积水的评估需要放射学或侵入性压力监测。尽管压力和剪切力延伸到整个大脑，但通常对脑室空间进行定性关注。在这里，作者提出了一种基于 MRI 的矢量方法，用于体素大脑和心室变形可视化和分析。 20 名新诊断急性脑积水的儿科患者（平均年龄 7.7 岁，范围 6 个月至 18 岁；14 名男性）需要手术干预回顾性图表审查后随机确定症状缓解。选择标准包括获取在 3T MRI 系统上执行的治疗前和治疗后配对 3D T1 加权体积 MRI (3D T1-MRI)。治疗前和治疗后的 3D T1-MRI 对均使用图像配准进行对齐，随后进行体素非线性变换以得出两个示例性的顺应性可视化：1）全脑矢量图在基线轴向成像上投影所得变形场； 2) 3D 热图投影沿脑室边界和大脑周边的体积变化。患者接受了以下脑积水治疗干预措施：内窥镜第三脑室造口术（n = 6）；脑室外引流管放置和/或肿瘤切除（n = 10）；或脑室腹腔分流术（n = 4）。术前和术后成像之间的平均时间为 36.5 天。干预后，心室容积显着下降（治疗前和治疗后平均容积分别为 151.9 cm3 和 82.0 cm3；p < 0.001，配对 t 检验）。相对于膝部和压部，最大程度的变形矢量变化发生在侧脑室空间。皮质层内变形矢量幅度的变化与年龄（p = 0.011，Pearson）以及心室大小和年龄之间（p = 0.014，Pearson）之间存在显着相关性，表明婴儿和幼儿的依从性较高这项研究强调了一种变形分析和矢量绘图的方法，可以作为脑积水患者治疗干预的地形可视化工具。未来一项将脑室变形程度或顺应性与颅内压相关联的研究可以阐明该技术在无创压力监测或非顺应性脑室病例中的潜在作用。

Hydrocephalus is a challenging neurosurgical condition due to nonspecific symptoms and complex brain-fluid pressure dynamics. Typically, the assessment of hydrocephalus in children requires radiographic or invasive pressure monitoring. There is usually a qualitative focus on the ventricular spaces even though stress and shear forces extend across the brain. Here, the authors present an MRI-based vector approach for voxelwise brain and ventricular deformation visualization and analysis.Twenty pediatric patients (mean age 7.7 years, range 6 months-18 years; 14 males) with acute, newly diagnosed hydrocephalus requiring surgical intervention for symptomatic relief were randomly identified after retrospective chart review. Selection criteria included acquisition of both pre- and posttherapy paired 3D T1-weighted volumetric MRI (3D T1-MRI) performed on 3T MRI systems. Both pre- and posttherapy 3D T1-MRI pairs were aligned using image registration, and subsequently, voxelwise nonlinear transformations were performed to derive two exemplary visualizations of compliance: 1) a whole-brain vector map projecting the resulting deformation field on baseline axial imaging; and 2) a 3D heat map projecting the volumetric changes along ventricular boundaries and the brain periphery.The patients underwent the following interventions for treatment of hydrocephalus: endoscopic third ventriculostomy (n = 6); external ventricular drain placement and/or tumor resection (n = 10); or ventriculoperitoneal shunt placement (n = 4). The mean time between pre- and postoperative imaging was 36.5 days. Following intervention, the ventricular volumes decreased significantly (mean pre- and posttherapy volumes of 151.9 cm3 and 82.0 cm3, respectively; p < 0.001, paired t-test). The largest degree of deformation vector changes occurred along the lateral ventricular spaces, relative to the genu and splenium. There was a significant correlation between change in deformation vector magnitudes within the cortical layer and age (p = 0.011, Pearson), as well as between the ventricle size and age (p = 0.014, Pearson), suggesting higher compliance among infants and younger children.This study highlights an approach for deformation analysis and vector mapping that may serve as a topographic visualizer for therapeutic interventions in patients with hydrocephalus. A future study that correlates the degree of cerebroventricular deformation or compliance with intracranial pressures could clarify the potential role of this technique in noninvasive pressure monitoring or in cases of noncompliant ventricles.